Archive for July, 2010

While the health care reform bill passed by President Obama means well, the state of Massachusetts has already tried something similar without much success. According to The Washington Post article “As Massachusetts health ‘reform’ goes, so could Obamacare,” columnist Robert J. Samuelson doesn’t believe that Obama’s plans will do much to solve the health care crisis. By putting caps on premium increases for companies like UPMC health insurance and other small and large insurers, it could easily put them out of business or into bankruptcy.

Massachusetts started by expanding the state-subsidized insurance coverage, but failed to get health care costs under control or make sure that people’s overall health actually is improving from this policy. Currently, the federal government plan has begun the same way. Most individuals in Massachusetts are required to compare health insurance coverage and purchase some form. Middle class families earning too much to qualify for Medicaid but with incomes less than three times above the poverty level receive state subsidies. Insurance coverage has increased from 87.5% of the (non-elderly) population in 2006 to 95.2% in 2009.

It’s hard to tell whether there has been any improvement in health since many uninsured people were young and healthy. It will likely take many years to determine that. But emergency rooms are still full, workers are taking home less pay because of their insurance costs, and less money is being spent on schools, police, prisons, roads, and more because of the increase in health care spending. While ideas have come about to help decrease overall health care costs and spending, such as per-patient fees combining doctors to make treatments higher quality rather than quantity, nothing has had enough of a blueprint to actually be tried. There is a dangerous possibility that this unchecked spending on healthcare will increase taxes and budget deficits and hardly show any health gains.

The newest option for health insurers is plans with limited networks. Companies like Cigna health insurance, Aetna, Wellpoint, and UnitedHealth Group are offering limited-choice plans to cut costs, according to “Health insurers promoting limited-choice plans to keep costs down.” The article, by Reed Abelson of The New York Times, says that while you will have fewer choices when it comes to doctors and hospitals, you will also pay a lower premium and save money with these limited-choice plans. Big cities like New York, San Diego, and Chicago have already had the plans tested and they are popular with small businesses as well as larger ones.

Both insurers and consultants are confident that even more businesses and individuals will see the benefits offered by these limited-choice plans. Company premiums will be reduced by as much as 15%, which is important in a time where money is one of the biggest concerns facing individuals and businesses. For those who want to keep their doctors or hospitals that aren’t covered in the limited networks, they will have to pay extra or make the decision to change. Many Americans who were previously uninsured will be helped by these lower premiums because they don’t have a doctor to leave; they’ll be able to choose from their limited list to seek treatment.

Smaller companies like Aultcare health insurance stand to gain a lot by offering limited-choice plans. The plans eliminate so-called “Gucci doctors” charging more for perceived better care. Employees will have to pay out of pocket to see such doctors if they choose a limited network option. Some employees offered the option of lower premiums for limited choices aren’t interested, so they continue to pay their higher deductibles and out-of-pocket costs to keep their large network. These limited-choice plans appear to work so that insurance companies can remain affordable to consumers looking to save wherever they can.

Massachusetts state regulators are trying to get skyrocketing health care costs under control. According to The Boston Globe article “State caps more health insurance rates” by Robert Weisman, 137 health insurance companies had their rates capped at 2009 levels. Fallon Health Plans and two others filed appeals on the decision; they will wait until later in the summer to find out what will come of their appeals.

Four companies in the small group market did have premium increases in the single-digits approved. Three insurers will be providing more information to the state before a decision is made on their requested double-digit increases. This latest decision is for the three-month period ending in September and is quite a different outcome than the last three-month period where nearly all of the premium increases were rejected.

While officials with the state argue that they are using these rate caps to help small businesses and working families struggling in a tough economy, insurance companies say that the rates officials are forcing upon them are wreaking financial havoc by making them operate at a loss. Insurers were given the ability to prove their case for increasing customers’ rates. If they can’t prove necessity, their rate increases will not be approved.

The top ten U.S. health insurance companies were recently rated by EquiTrend. A press release from Blue Cross Blue Shield announces them as the top rated health insurance brand in the survey. “Blue Cross/Blue Shield Highest Ranked Health Insurance Company Among Consumers” highlights the top six health insurers. Aetna health insurance came in ranked second by consumers followed by United Healthcare, Kaiser Permanente, CIGNA, and Humana. The study to determine these rankings asked consumers about trust, equity, the connection to consumers, energy, commitment, and brand behavior and equity.

Many Americans will become more involved in choosing their health insurance company with the coming health care reform. Instead of just going with the company that their employer offers coverage through, consumers will be researching ways to cut costs and maintain benefits as more of the health care burden is shifted to them. Health care reform can bring about billions of dollars in revenue to insurance companies, but they’ll have to make the right marketing moves in order to get this new business. Consumers’ perception of a company is just as important as their product, cost, and benefits since it can be hard to tell the difference in companies by those latter factors.

From the Associated Press’ Marilynn Marchione, “Treating HIV also prevents its spread, study finds.” A recent Canadian study, partly funded by the United States, found that the rate of AIDS infections decreased in the areas of Canada where more people started taking drugs for the disease. Infections dropped by 3% in British Columbia, where the study was performed. Since 1996, the number of new infections has been reduced by half, which correlates with a rise in treatment since Canada has offered free AIDS care and the introduction of modern AIDS drug treatments. The director of the U.S. National Institute of Allergy and Infectious Diseases states that where there is more drug therapy there is less transmission. He says that there is really no other explanation for the drop in news AIDS cases in Canada.

While the U.S. does not offer free treatment to everyone, Fallon Health Insurance and other health insurers often cover the cost of drug therapy for AIDS patients. With 1.1 million HIV infected Americans, AIDS experts hope that the results of this study will help improve U.S. funding for AIDS patients to get drugs. While there are 55,000 new cases of AIDS each year in the U.S., that is a number that hasn’t increased or decreased in a decade or so. Since AIDS is incurable, it is crucial to find a way to stop the spread of the disease. Previous studies in Africa showed similar results, as did studies indicating that pregnant women taking AIDS drugs are less likely to pass the disease on to the unborn fetus. An increased effort in Washington, San Francisco, and New York to test and give early treatment to more people will hopefully be taken throughout the U.S. soon.

In the article “Ask Kim: The ABCs of the new Medigap plans,” Kimberly Lankford of Kiplinger’s Money Power explains the recent Medigap changes. Two new Medicare supplement plans were introduced on June 1, Medigap plans M and N. Plans E, H, I, and J will no longer be offered as Medigap plans. Anyone who wants to keep their old plan, even those that have been discontinued, is able to do so with no changes. It might be a good idea to compare health insurance options though, because the new plans offer lower premiums in exchange for some cost-sharing.

The new plans are both similar to Medigap’s most popular policy, Plan F. The difference with Plan M is that it only covers half of the Medicare Part A deductible of $1,100 and does not cover any of the $155 Part B deductible. While Plan N does cover the full Part A deductible, it has the added expense of co-pays for doctors visits ($20) and emergency room treatment ($50). Medicare Part B “excess charges” are not covered by either Plan M or N.

More insurers like Golden Rule Health Insurance are offering Plan N than Plan M. The cost is about 30% less than Plan F. While you’ll be paying less for your policy, take into account the additional co-pays, Part B deductible, and any Part B “excess charges” you may have to pay out of pocket with Plan N before switching. It might still work out to your benefit to change plans. People eligible for the first time for Medicare Part B within 6 months will automatically qualify for Medigap plans. Once that enrollment period ends, you could be disqualified for health conditions. There are insurers offering Plans M and N regardless of health conditions though.

Those who spend too much time in the sun soon realize that their skin is paying the price through photoaging, lines, wrinkles, and age spots. These premature skin problems can make you look older than your actual age. Andrea Markowitz of Health Key suggests treatment options in “Treating Sun-Damaged Skin.” There are a number of things you can do to revitalize dry and patchy skin and fade spots, lines, and wrinkles.

Check with insurance companies like Aultcare to see if they cover these dermatological treatments. There are many non-surgical treatments that you can get to improve the look of your skin. Botox softens wrinkles; chemical peels remove the top layer of your skin to reveal an improved look; and collagen injections can help fill lines, wrinkles, and even scars. Dermabrasion abrades the skin and causes new smoother skin to grow. Microdermabrasion is a milder form that can be used for moderate skin damage. Tazarotene is a retinoid cream that can reduce photoaging signs. Tretinoin is another cream which treats wrinkles and other skin problems.

There are surgical treatments that can take a more intense approach to skin correction. With laser skin resurfacing, the appearance of wrinkles and scars can be reduced. Non-ablative resurfacing is a laser treatment that also uses electrical energy to correct skin. Intense pulsed light therapy is another surgical treatment that can be used to correct sun damaged skin. If

Assurant Health or another insurer does not cover treatments, there are some over the counter remedies that will save money. Creams and lotions with retinol, copper or copper peptides, alpha-hydroxy acids, or antioxidants can help improve the appearance of your skin. Most importantly though, take care of your skin by always wearing sunblock and hats whenever possible.

Individual health insurance rates have increased by as much as 20%, compared with employer-sponsored group plan increases closer to 5%. In the Associated Press article “Survey: Individual health insurance premiums jump,” Tom Murphy summarizes the results found in the Kaiser Family Foundation’s new survey. Although individual insurance plans increased by 20%, consumers were able to compare health insurance rates at other providers causing many to switch. Switching providers lowered the average price increase to 13%, still much higher than the employer-sponsored family plan increase of 5%. Individual employer-sponsored plans stayed almost the same from year to year.

The individual health insurance market is used by 14 million or so Americans under the age of 65, while 157 million participate in employer-sponsored plans. Anthem Blue Cross Blue Shield of California came under fire last year for their request of 20% premium increases, but they argue that the increases are fully necessary. All of these individual health insurance increases most likely added to the health care reform debate and the bill that was passed in March. Almost half of the people surveyed purchase individual health insurance because they are self-employed or own small businesses. We’ll see what the health care changes bring about for the individual market’s costs.